Healthcare Provider Details
I. General information
NPI: 1013899731
Provider Name (Legal Business Name): ECC ANCILLARY SERVICES, P.C.
Entity Type: Organization
Gender:
Sole Proprietor:
II. Dates (important events)
Enumeration Date: 07/23/2025
Last Update Date: 07/23/2025
Certification Date: 07/15/2025
Deactivation Date:
Reactivation Date:
III. Provider practice location address
2200 WHITNEY AVE STE 380
HAMDEN CT
06518-3602
US
IV. Provider business mailing address
2200 WHITNEY AVE STE 380
HAMDEN CT
06518-3602
US
V. Phone/Fax
- Phone: 203-281-3636
- Fax: 203-287-2934
- Phone: 203-281-3636
- Fax: 203-287-2934
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 207L00000X |
| Taxonomy | Anesthesiology Physician |
| License Number | |
| License Number State | |
VIII. Authorized Official
Name: DR.
MICHAEL
LOIACONO
Title or Position: MEDICAL DIRECTOR
Credential: D.O
Phone: 203-281-3636